Now that Chief Justice John Roberts has upheld President Barack Obama's health care law, the chief has fallen off so many conservative Christmas lists that some sound eager to revoke his citizenship.

They'll get over it, I'm sure. But as its opponents talk about changing the dreaded "Obamacare" -- through election victories, they hope -- they remain curiously vague about what they want to change it to, or whether they really want to change it at all.

For example, when Senate Republican Leader Mitch McConnell was asked how his party would provide coverage to
the nation's 30 million uninsured, he sounded like those folks had nothing to do with the debate.

"That is not the issue," Sen. McConnell told "Fox News Sunday" host Chris Wallace. "The question is how to
go step by step to improve the American health care system. It is already the finest health care system in the world." Yet,
he still wants to "improve" it? Without caring about the uninsured?

Struck by the senator's burst of candor, Wallace interrupted, "You don't think 30 million uninsured is an issue?"

"We're not going to turn the American health care system into a western European system," McConnell said. "That's exactly
what is at the heart of Obamacare. They want to ... have the federal government take over all American health care. The
federal government can't handle Medicare or Medicaid."

Here we go again.

The senator sounded like a replay of the Grand Old Party's talking points from the health care debates of
three years ago, when Obamacare was a mere glimmer in its cosponsors' eyes.

Joining him in the Way-Back Machine was Republican House Speaker John Boehner on CBS' Face
the Nation. The law has to be "ripped out by its roots," he told guest host Norah O'Donnell and
Congress should "start over." Oh, joy. Just what we need -- a replay of the debate that Republicans now blame
for distracting him from the nation's economic woes.

Instead of offering some new ideas, Republican leaders sound content to fight over the old ones, like the mandate that
requires everyone to purchase insurance, the central issue of the Supreme Court case.

"The idea that the federal government can mandate that the American people purchase a product is shocking to me," Boehner
said. Yet, Justice Roberts zeroed in on an essential truth: Our Constitution may not allow government to
force you to buy something but it does allow government to tax you for not buying something.

Republicans were delighted to hear Roberts confirm that Obama was the tax-raiser they'd been calling him all along -- until
presumptive Republican nominee Mitt Romney's top aide, Eric Fehrnstrom, agreed with the Obama
position. That's because Romney included a similar penalty in "Romneycare," as his opponents dubbed the health care plan he
passed as governor of Massachusetts.

Both sides focused more attention on whether the penalty was a tax than on what the penalty-tax was for -- funds to offset
the costs to insurers of insuring people with pre-existing conditions. What remains unsettled, now that the Supreme
Court suspense is over, are the big questions about the future of health care, especially such unsexy questions as
costs and coverage.

McConnell justly praises "the finest health care system in the world," but that's only for those who can afford to have
access to it. Americans already spend more than 16 percent of our gross domestic product on health care -- or nearly twice
the average of other developed nations, according to the international Organization for Economic Cooperation and
Development.

And costs are skyrocketing, even without Obamacare. Employer-sponsored health insurance premiums have more than doubled
in the last nine years, according to the Kaiser Family Foundation, a rate that is three times faster than wage
increases.

Yet for all the complaints that the political right has raised, including the tea party movement that
tilted Congress toward the right in 2010, few in a leadership position have offered much in the way of a
serious alternative or a willingness to engage in a serious debate over possible improvements. I guess seriousness will
have to wait until after the election.